A practical sketch of the Asiatic cholera of 1848 : its rationale and (presumed) pathology / by S.F. Statham.

Date:
1852
Catalogue details

Licence: Public Domain Mark

Credit: A practical sketch of the Asiatic cholera of 1848 : its rationale and (presumed) pathology / by S.F. Statham. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    taueous deposit (of fibrin ?) takes place between the glands (in the cellular tissue of Pcyer’s patches) ; hence the patches become raised, opalescent (and flooculent on the surface), often with bright injection, and later with pits in place of glands ; further than this, changes do not occur, for by now, death, secondary fever, or recovery is induced, or result on subsidence of the diseased state of the intestines. The state of the great intestine is similar ; its solitary glands are found like those of the small intestines, as self-registering thermometers, evidences of the increased action which has been going on. I may mention here that these changes, though trifling, acquire importance from their constancy, and from not occurring in health; of twenty-five cases, in former post-mortems in which I have examined the intestines, the solitary glands of the small intestine have been enlarged in but three cases, and in all of these diarrhoea had been present during life; there was redness around the spaces for the glands in the large intestine in three or four cases, but in all of these constipation existed to a great extent. I have never seen a similar uniform injection around the glands of Peyer, or so extensive in the mucous membrane. In those cases under Dr. 'Williams, at University College Hospital, there has been frequently some redness where there had been diarrhoea previously, and this at very variable times after death, from fifteen to thirty hours ; but in all of these it was very slight, and in several at the same time after death where it would have been expected there was none. In three cases of erysipelas the redness had entirely disappeared in four, twelve, and fourteen hours; similarly, I believe that the intestinal redness in cholera disappears after death, unless it had previously disappeared by the cessation of inflammation. Of the Algide Cases.—In the first case (J. Y.), examined twenty hours after death, both causes came into play ; and, as most of the solitary glands had probably burst, and the examination was hastily made, but little evidence was found; in two other men, examined twenty-one hours after death, there was no redness, but the other signs of inflammatory action; while in three examined at seventeen, ten, and two-and-a-half hours after death, there was more or less extensive injection about in proportion to the time which had elapsed ; all these six dying in the collapsed stage. (See Appendix.) The redness is probably more permanent than in erysipelas, on account of the increased spissitude of the blood, the portal circulation, and the venous congestion from difficulty of passing through the lungs; the lessened bulk of the blood would not give less redness from the great quantity of it present in internal organs. That the disappearance of the capillary redness is so complete is probably duo